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NPI Code Detail

MEDICARE: MRS. SAMANTHA RAE JENNINGS MA-SLP

MEDICARE: MRS. SAMANTHA RAE JENNINGS MA-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist3815KS

General Provider Information

NPI Number : 1962139188
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SAMANTHA RAE JENNINGS MA-SLP
Provider Business Mailing Address
First Line : 641 N BURNS AVE
Second Line :
City : VALLEY CENTER
State : KS
Zip : 67147-2626
Country : US
Telephone Number : 620-655-2233
Fax Number :
Provider Business Practice Location Address
First Line : 3001 IVY DR
Second Line :
City : NORTH NEWTON
State : KS
Zip : 67117-8001
Country : US
Telephone Number : 316-284-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2022
Last Update Date : 08/07/2022

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Directions to “ MRS. SAMANTHA RAE JENNINGS MA-SLP” Practice Location

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